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Military Health System

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Form/Template
Jun 12, 2023

340b Verification Form

.PDF | 203.71 KB

340b Verification Form to be completed by the manufacturer and pharmacy for any 340b claim disputes.

Form/Template
May 31, 2023

De Identification Plan Template May 2023

.PDF | 154.64 KB

Use this updated template to provide the de-identification process to be used for your project. The plan should show how MHS sensitive data elements (or quasi-identifiers) will be de-identified as well as how the 18 HIPAA identifiers will be handled.

Form/Template
May 17, 2023

81st MDG Keesler AFB MEDCOI

.PDF | 741.21 KB

Privacy Impact Assessment, 81st Medical Group (MDG) Keesler Air Force Base (AFB) Medical Community of Interest (MEDCOI).

Form/Template
May 17, 2023

CIS MIL Enclave PIA

.PDF | 741.62 KB

Privacy Impact Assessment, Clinical Information System (CIS) -.mil Enclave.

Form/Template
May 17, 2023

72ND MDG TINKER AFB MEDCOI 508 COMPLIANT

.PDF | 737.49 KB

Privacy Impact Assessment, 72nd Medical Group (MDG) Tinker Air Force Base (AFB) Medical Community of Interest (MEDCOI).

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